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Clarification – Medical Utilization Management Program Updates for Safety Net Members Effective January 17

Audience: All providers, facilities, hospitals

Our bulletin issued December 10, 2019, notified you that preauthorization requirements for some services for Safety Net members would be lifted effective January 17, 2020. In addition, be advised that preauthorization is NOT required for the following codes shaded in gray as of January 17. Safety Net includes: Univera Healthcare MyHealthSM, Univera Healthcare MyHealth PlusSM, and Child Health Plus.

Safety Net Codes Removed from Preauthorization
0376T, 33977, 33978, 33980, E0935, K0001, L8607, L8614, V2221, V2321, V2410, V2430, V2500, V2501, V2502, V2503, V2510, V2511, V2512, V2513, V2520, V2521, V2522, V2523, V2599, V2600, V2610, V2615, V2623, V2624, V2625, V2626, V2628, V2629, V2702, V2710, V2715, V2718, V2755, V2770, V2780, V2782, V2783, V2784, V2785, V2786, V2788, V2790, V2797, S0580

Please refer to our December bulletin for additional details about the update to our preauthorization program. If you have questions, contact your Provider Relations representative.

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